Temporal Trends and Demographic Disparities in Mortality Due to Coronary Artery Disease and Hypertension in Adults Aged 25 and Above in the United States (2000 to 2024).

INTRODUCTION

Coronary artery disease (CAD) remains a leading cause of mortality, and hypertension serves as a primary, modifiable risk factor. While cardiovascular mortality historically declined, recent data indicate this trajectory has plateaued and begun to reverse. This study analyzes the temporal trends and demographic disparities in mortality due to CAD and hypertension among adults in the United States.

METHODS

This retrospective study utilized the CDC WONDER database to extract mortality data from 2000 to 2024. Deaths among adults aged 25 years and older with CAD and hypertension were identified. Age-adjusted mortality rates (AAMRs) per 100 000 population were calculated. Temporal patterns and annual percent change (APC) were evaluated using Joinpoint regression analysis.

RESULTS

Between 2000 and 2024, 3 776 396 deaths occurred due to CAD and hypertension among US adults. Overall AAMR rose from 57.22 to 76.95, driven by a steep 2018-2021 increase (APC: 10.13%) before a recent decline (2021-2024, APC: -3.50%). By 2024, male AAMR (106.43) doubled female AAMR (52.68). Non-Hispanic African American adults experienced the highest AAMR (96.90). Non-metropolitan areas saw greater sustained increases (AAPC: 2.79%) than metropolitan areas (AAPC: 1.23%), with the South recording the highest regional AAMR (70.25; AAPC: 1.53%). While essential hypertension mortality stabilized, hypertensive heart disease (AAPC: 4.35%) and renal disease (AAPC: 8.83%) surged. Chronic ischemic heart disease remained the leading CAD subtype (AAPC: 1.37%).

CONCLUSION

CAD and hypertension-related mortality among adults has increased significantly over the past 25 years, exposing significant demographic disparities. Targeted public health strategies prioritizing optimal blood pressure management and equitable healthcare access are essential to mitigate this escalating burden.